Last week Leroy started with an IBD flare-up. It’s the first flare-up in quite a while and I know it’s not the last but every flare-up is scary and different.
I had a feeling that it was coming because I felt some edema on his right ear flap. I kept a close eye on him as soon as I noticed but everything else seemed to be fine until he had a bout of diarrhea on our walk in Friday.
DO NOT PANIC
DO NOT PANIC
Is all that went through my mind as I stared at the pile of loose stool splattered on the sidewalk in front of me.
I was talking on the phone with my mom and she could tell I was frazzled so we said goodbye and I anxiously walked home.
Part of me wanted to just load Leroy up in the car and drive him straight to the vet but by the time I got home I had calmed myself down I went and checked the backyard to see if I could see any signs of when the diarrhea might had started. On my diarrhea exploration I found one pile of diarrhea which led me to believe, since I just did a full poop scoop 2 days prior, that the diarrhea had started in the morning.
Next I went, upstairs and grabbed the Metronidazole and began the emergency diarrhea protocol.
When Leroy has an IBD flare-up we either have an emergency diarrhea protocol or just a diarrhea protocol. The difference is if he is showing signs of edema. If he’s showing signs of edema and has diarrhea that means that things can go very bad very quick because the Lymphangiectasia is rearing it’s ugly head and it needs to be addressed and handled.
For those that are unfamiliar with Intestinal Lymphangiectasia, it is an intestinal disease in which the ducts carrying lymph leak protein and other substances into the intestinal tract. This can cause, abnormal fluid accumulations and weight loss. It can be a life-threatening condition if it’s not addressed as we learned the hard way 3 years ago. Leroy’s Lymphangietasia is secondary to his IBD, or so we are told.
So when that happens here is what we do:
Contact our veterinarian. The most important thing is to make contact with our veterinarian and discuss our options. In this case, since the diarrhea had just started and Leroy was still eating, the veterinarian felt that we could start the medications we have at home and give it the weekend to see if things improved.
Start Metronidazole. Metrondidazole ia flaygl and it’s like an antibiotic for the bowels. We always have this on hand in case of diarrhea.
Withhold food for 12 hours. This is an important step because it allows the bowels to settle down and have a rest. If you continue to feed a dog that has an upset stomach the inflammation doesn’t have time to settle down because the food keeps irritating it. Then add food gradually. You don’t want to feed the regular amount, you want to start off small and slowly increase to make sure that they can tolerate it. We usually start off feeding Leroy about 1/4-1/2 amount of his regular feedings.
Start a bland diet. Leroy’s already on a bland prescription diet but we have to get even blander and we have to keep his diet low-fat and low protein. Why? Because when fat is consumed it’s transformed into lymph. ( Lymph is the fluid that circulates throughout the lymphatic system). The lymph has to be carried through the ducts in the intestines but since the ducts are blocked the lymph has nowhere to go so it begins to build up in the intestines and then in the body.
By limiting a dog’s fat intake, we can reduce the amount of intestinal lymph that is formed, which reduces pressure in the ducts. Less pressure means less lymph leakage and a reduction of symptoms. The lymph that leaks into a dog’s intestines with Lymphangiectasia also contains a lot of protein so we want to limit that loss by limiting the amount of low quality protein that is being consumed. Any protein that is consumed should be of high quality.
We chose to do boiled chicken and rice because Leroy tolerates it well. As soon as his poop starts to firm back up we will add in mashed sweet potatoes in place of the rice since sweet potatoes contain many key vitamins that need to replenished in Leroy’s body in case they were lost. Treats all get cut except for his CBD/Hemp treats and fat-free/salt free rice cakes. Once he starts to get better I sometimes add in a little fat-free whipped cream to the rice cakes so that he doesn’t think that his life totally sucks.
Increase walking. In the winter our walks vary, if the weather is bad I tend to slack off. If Leroy is possibly having fluid build up and is physically able to walk, we walk to keep him moving. We’ll do short walks a few times a day. One thing I really pay attention to is that his legs aren’t swelling. If his legs are swelling he has a hard time walking and standing up and that means the fluid has moved to his limbs. In this flare-up there has been no fluid in his limbs which is great.
CBD/Hemp Oil. This will be the first time that I’ll be using CBD oil to specifically treat Leroy’s IBD so I’ve increased his dosed of treats and oil. Why? In current studies taking place, CBD has been shown to reduce inflammation and help intestinal disorders in dogs. If I can reduce Leroy’s inflammation by using a safer product like CBD/Hemp oil instead of steroids that would be wonderful and much better for his body.
Monitoring, monitoring, monitoring. It’s imperative that I monitor Leroy’s condition closely. I check his stool every time he goes and I check his legs for fluid build up several times a day. I make sure he’s eating and I check his vitals at least once a day. I check his vitals to make sure he isn’t having labored breathing which would be due to fluid accumulating around his lungs.
Probiotics. Leroy’s on a daily dose of probiotics year round to help keep the good bacteria in his gut.
The wrap-up. Leroy seems to be responding well to the treatment. His stool, while still a little soft, is almost back to normal and the edema in his ears is basically gone. He’s maintained his appetite through this whole flare-up which is great. As long as he continues to move in the right direction my next step will be to take him in to have his albumin levels checked to make sure that his protein levels are where they need to be.
Leroy has a scary condition and since Lymphangiectasia can be fatal if unresponisve to treatment, it’s taken me quite a few years to feel confident in the choices that I make for him on a daily basis. The more that I know about the condition and how Leroy reacts to the treatment increases my confidence that we can fight this disease successfully for years to come.
The reason why I share this information is not to give medical advice to anyone who is dealing with Intestinal Lymphangiectasia, but to share Leroy’s story and what has worked for him. There’s not a lot information out there about Lymphangiectasia and treatment seems to vary greatly from dog to dog. If 1 thing I mentioned here helps another dog, than that is awesome.
**As of 3/18/18 Leroy’s albumin was 1.7. Low normal is 2.6 in dogs. We’ve started him back on a full dose of steriods and have been able to adjust him down to 10mg once a day. We’ll recheck his levels again at the end of April. Everything else looks good and he’s maintaining his weight at 150 pounds so we’re hopeful he’ll rebound once again.